Requested supplemental support for patient costs. Largely because of increases in patient costs from the time our initial proposal was drafted, our patient support is drastically underfunded. In the next fiscal year, for example, we were allocated funds to pay costs of implantation for 3-4 patients (including no surgeon's fees, which are donated). In fact, that will not pay the costs of 2 procedures (as is illustrated in the breakdown of patient costs listed below). In addition, we have to pay the cost of surgical replacement of through-the-skin devices with wholly implantable devices (now being fabricated). The patient costs for this procedure, at this experimental phase, are considerable/procedure. Both existing patients will have to have their devices replaced with permanently wearable devices in the coming fiscal year (we have already exceeded the testing periods outlined in our original grant protocol). One is indigent; the other has very limited resources. We have no possible implant patients near the top of our patient selection lists who could pay their own hospitalization and surgical expenses. Without the additional monies we would have difficulty in even paying the costs of replacing the percutaneous plugs with wholly implanted devices in the two patients who are already implanted. Supplemental support would allow us to implant two additional patients and insure the orderly conduct of this grant.